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Murine Kidney Transplant Technique
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Gastrointestinal bleeding in a kidney transplant recipient
Clinical Nephrology
|January 12, 2024
Summary
Gastrointestinal bleeding in kidney transplant recipients can rarely be caused by opportunistic fungal infections like histoplasmosis. Early diagnosis via colonoscopy and biopsy, followed by antifungal treatment, is crucial for successful outcomes.
Area of Science:
- Mycology
- Transplant Infectious Diseases
- Gastroenterology
Background:
- Opportunistic infections are a significant concern in immunosuppressed individuals, particularly organ transplant recipients.
- Gastrointestinal bleeding (GIB) is a known complication, but opportunistic fungal causes are infrequently reported, posing diagnostic challenges.
Observation:
- A kidney transplant recipient presented with acute lower gastrointestinal bleeding as the sole initial symptom.
- Colonoscopy revealed characteristic scattered punchout circular colonic ulcers.
Findings:
- Biopsies of the colonic ulcers showed budding yeasts, confirming disseminated histoplasmosis.
- The patient received a prolonged course of intravenous amphotericin B, followed by oral itraconazole.
Implications:
- This case highlights the importance of considering rare opportunistic fungal infections, such as histoplasmosis, in the differential diagnosis of GIB in transplant patients.
- Prompt endoscopic diagnosis and appropriate antifungal therapy are essential for managing this potentially life-threatening condition in immunocompromised hosts.
